ReviewJournal of spine surgery (Hong Kong)2020
Sagittal alignment of the cervical spine: do we know enough for successful surgery?
Review in Journal of spine surgery (Hong Kong), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 55 citations in OpenAlex.
- Cervical Sagittal Alignment and Patient-Reported Outcomes in Posterior Cervical Fusion: A Longitudinal Comparative Cohort Study.International journal of spine surgery · 2026Article
- Anterior Cervical Osteotomy: A Narrative Review and Proposal of a Mechanism-Based Decision Framework (The ACO Triad).Global spine journal · 2026Review
- Article
- A systematic review and meta-analysis of sagittal cervical spine parameters: Normative values, correlation with quality of life, and biomechanical modeling.North American Spine Society journal · 2026Review
- Preoperative Alignment and Interbody Cage Design Influence Radiographic Outcomes Following Anterior Cervical Discectomy and Fusion.Journal of clinical medicine · 2026Article
- Radiological Factors Affecting Cage Subsidence after Single-level Anterior Cervical Discectomy and Fusion with Double Titanium Cylindrical Cages.Neurologia medico-chirurgica · 2026Article
- Age-associated differences in cervical sagittal alignment parameters among asymptomatic adults: a cross-sectional reference study.Frontiers in neuroscience · 2026Article
- Three novel orbito-cervical parameters: highly repeatable and simple measurements of horizontal gaze.Spine deformity · 2026Article
- Long-term stability of reducing cervical kyphosis via Chiropractic BiophysicsJournal of physical therapy science · 2026Article
- Long-term loss of intervertebral disc height after posterior cervical surgery for ossification of the posterior longitudinal ligament: a retrospective study with more than 3 years of follow-up.Journal of orthopaedic surgery and research · 2025Article
- What Are the Medium-term Reciprocal Changes in Cervical Sagittal Alignment After Posterior Correction for Lenke 5C Adolescent Idiopathic Scoliosis?Clinical orthopaedics and related research · 2025Article
- Unveiling and Validating a Modified Method to Assess Cervical Sagittal Alignment as an Effective Substitute for Conventional C2-7 Cobb Angle.Clinics in orthopedic surgery · 2025Article
- Objective test findings in patients with chronic eye symptoms seeking care at an outpatient neck center: ligamentous cervical instability etiology?Frontiers in neurology · 2025Article
- Influence of subaxial cervical spine surgery on the sagittal alignment of the cervical and global spine. A prospective observational study.Brain & spine · 2025Article
- Sagittal Full-Spine vs. Sectional Cervical Lateral Radiographs: Are the Measurements of Cervical Alignment Interchangeable?Journal of clinical medicine · 2024Article
- Article
- A novel classification that defines the normal cervical spine: an analysis based on 632 asymptomatic Chinese volunteers.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Cervical Sagittal Balance: Impact on Clinical Outcomes and Subsidence in Anterior Cervical Discectomy and Fusion.Biomedicines · 2023Article
- Axial superior facet slope may determine anterior or posterior atlantoaxial displacement secondary to os odontoideum and compensatory mechanisms of the atlantooccipital joint and subaxial cervical spine.European radiology · 2023Article
- Sagittal sequence and clinical efficacy of cervical disc replacement and hybrid surgery in the treatment of cervical spondylotic myelopathy: a retrospective study.Frontiers in surgery · 2023Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Over the past decade, there has been growing interest in the sagittal alignment of the cervical spine and its correlation to clinical outcomes. It is now known that cervical lordosis is not universally physiological and should not be pursued in all patients undergoing surgery. Rather, it is increasingly understood that it is how these angular parameters (lordosis or kyphosis) interact with translational parameters that is reflective of overall cervical spine and whole spine balance, which in turn impacts patient outcomes. This review synthesises currently available evidence relating to the sagittal alignment of the cervical spine. Radiographic assessment of the cervical spine including horizontal gaze is discussed and alignment in physiological and pathological states analysed. The interdependence of spinal segments is reviewed, with cervical alignment correction influencing the adjacent thoracic spine, and similarly lumbar lordosis (LL) and global balance correction changing cervical spine alignment. Cervical kyphosis with associated cervical sagittal imbalance is known to lead to poorer post-operative outcomes, and this dichotomy in outcomes has not been shown to improve even with alignment correction. Further work is required to uncover the extent to which cervical spine alignment correction should be attempted toward improved patient outcomes, in order to plan and deliver patient-specific surgical realignment targets.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.